Provider Demographics
NPI:1811423577
Name:STEWART, CATHERINE MILLER (PT, DPT, NCS)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:MILLER
Last Name:STEWART
Suffix:
Gender:F
Credentials:PT, DPT, NCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 MUSEUM WAY
Mailing Address - Street 2:NO. 3206
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-3080
Mailing Address - Country:US
Mailing Address - Phone:704-619-0905
Mailing Address - Fax:
Practice Address - Street 1:6913 CAMP BOWIE BLVD
Practice Address - Street 2:SUITE 141
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-7163
Practice Address - Country:US
Practice Address - Phone:682-312-7693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12093602251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology